Our Top Blog Posts From 2021

By Dr. Sean M. Wells, DPT, PT, OCS, CNPT, ATC/L, CSCS, NSCA-CPT, Cert-DN

Our team has gathered copious research and written many blog posts in 2021. From gut biome studies to intermittent fasting, we have perused the literature to bring you the best in regards to nutrition specific for physical therapy practice. Much confusion and controversy still exists within nutrition science, but you, our fellow nutritional PT loyalist, have shown us the content you love the most. As such, we wanted to offer you a nice summary of what you liked the most from 2021.

Intermittent Fasting

Having such robust data on hoppers and mice is great, but what about human studies and the impact on physical therapy practice? A well-done systematic review outlines some of the following benefits for humans who undertake IM:

1. Improved stress response
2. Lowered cholesterol
3. Lowered blood pressure
4. Improved insulin response

Understanbly such benefits could help many patients in cardiac...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

Autism is a condition that affects nearly 1 in 50 children. Covering a wide spectrum of symptoms, autism is often associated with delayed milestones, difficulty socializing, and/or sensitivity to sensory stimuli. The main cause of autism still remains to be seen; however, there is compelling evidence that individuals with autism have a markedly different gut microbiome compared to normally developed children. Such thinking has lead to alternative therapies and treatments, which many parents may pursue to help their child improve their autism symptoms. Fortunately, data from a recent study in Cell sheds light on the gut biome differences and how some alternative therapies may not ideal.

Chloe Yap from Mater Research and The University of Queensland said the team examined genetic material from the stool samples of 247 children, which included 99 children diagnosed with autism. After examining the diet and stool...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

Diet crazes come and go in the hopes to correct health issues and for weight loss. Many diets are merely fads, not backed by evidence, and/or offer only short-term solutions. One dietary pattern that stands out from the pack is calorie restriction (CR), especially in regards to data on longevity. I have 2 peer-review publications in the area of CR and intermittent fasting, so I can share both the data and experiences of this diet. Let's take a quick look at calorie restriction and what physical therapists (PTs) need to know!

Calorie restriction is a dietary regimen where a person consumes typically 25-40% less calories than usual. In order to accomplish this calorie deficit a person must know their total daily caloric needs over several days. Calculating 25-40% of this total calorie needs a client can then reduce their calorie content of each meal in order to hit their calorie deficit. Usually there is not...

By Dr. Sean M. Wells, DPT, PT, OCS, ATC/L, CSCS, NSCA-CPT, CNPT, Cert-DN

For decades the predominant model that dictated weight gain, loss, or maintenance was the energy balance model (EBM). The EBM is rooted in one of the basic laws of thermodynamics. It goes without saying that food contains energy and it is typically measured in a unit known as calories (kilocalories in the dietary world). As a person consumes food it provides energy to do work such as exercise, activities of daily living (ADL), physical therapy, basic living functions, or even sport. Energy can come from recently consumed food or stored energy (e.g. fat, glycogen, or protein) from previously eaten food. 

Clinicians often explain weight loss to patients as “calories-in versus calories-out” or CICO, which directly relates to the EBM. In brief, CICO helps rehab professionals to explain to clients the balance between the energy coming into their body versus the energy they expend: too much food...

By Dr. Sean M Wells, DPT, PT, OCS, ATC, CSCS, CNPT, NSCA-CPT, Cert-DN

Exercise is certainly medicine but what if we could do more for our older adult clients? As physical therapists (PTs), occupational therapists (OTs), or personal trainers we strive to push our clients with the best exercise selection and most evidenced-based techniques to improve our clients’ strength, balance, and function. But what if all we are doing is for not because of a client’s poor diet? 

I have seen this time and time again in my clinical practice: a client enters my practice, I examine them and find weakness and balance deficits; we begin a program of resistance training, balance and neuromuscular work, and notably see little change in their function. As I dive deeper into their lifestyle factors (e.g. sleep, stress management, and nutrition) I find they don’t eat enough, drink too much alcohol, and consume overly processed foods devoid of essential nutrients.  Could these...

By Dr. Sean M Wells, DPT, PT, OCS, ATC, CSCS, CNPT, NSCA-CPT, Cert-DN

Since the 1980s many dietary guidelines promoted the notion of a low-fat diet in order to reduce cardiovascular disease (CVD) risk. Over the next 30 to 40 years healthcare providers and nutrition researchers found that simply lowering dietary fat alone is not the only answer to reducing heart disease. This is likely because those consuming a low-fat diet may still include junk foods, meat, and smoking -- which have all be directly correlated with higher risk of heart disease, comorbidities, and mortality. Data show that most plant-based oils and fats from sources like nuts, seeds, and some oils can actually be beneficial in lowering heart disease risk. Could a plant-based diet, which includes fats from plant-sources, be better than a low-fat diet? A recent publication provides physical therapists and other providers just the answer.

The new research, coined Coronary Artery Risk Development in Young Adults...

By Dr. Sean M Wells, DPT, PT, OCS, ATC, CSCS, CNPT, NSCA-CPT, Cert-DN

Three out of four Americans takes some form of dietary supplement every day. From multivitamins to weight loss supplements, the list of dietary supplements is long and the associated costs can be substantial. Physical therapists (PTs) work with a wide range of patient types, many of whom are actively taking supplements for health, to slow aging, or in hopes to reverse a disease state. Obviously these supplements must have some positive impact on our health, right? Doctors of physical therapy (DPTs) are becoming more holistically trained to understand the role of nutrition and dietary supplements: despite this, the answer to above question is convoluted and may even surprise you.

Regulation

Dietary supplements are not regulated by the Food and Drug Administration. This is vastly different than the drugs that many of our patients are taking. The lack of regulation should be a mainstay reason why...

By Dr. Sean M Wells, DPT, PT, OCS, ATC, CSCS, CNPT, NSCA-CPT, Cert-DN

Can you recall a recent treatment session or patient case where you connected with another fellow physical therapist (PT), occupational therapist (OT), or speech therapist (ST)? Overall the treatment session or case probably went well, right? Both you and the other provider worked together, solved several problems, and/or potentially identified major issues that changed the course of rehabilitation. 

In this example it is easy for us in rehabilitation to see how easy it is to collaborate with other rehab professionals -- but what about dieticians? My team and I have long argued that PTs ought to work more collaboratively with these healthcare providers. Let me delve into several reasons why and examples of how nutrition collaboration benefits all.

Dietitians' Education

Dietitians are educated and clinically trained to work with many challenging populations. Their 4 year college education and clinical training...

For the last several decades low carb advocates have pitched their diet as means to weight loss, better glycemic control, and even life extension. Many avid fans, like Noakes and Attia, have thrown around several low level studies or short term studies to support the low carb dietary pattern. Meanwhile, the data for more plant focused, carb rich diets like the Mediterranean and Whole food plant based diets have been gleaning more and more support. From prospective trials to population and epidemiology data, such plant focused diets seem to be the ideal pattern for physical therapists (PTs) to recommend to many clients. Let's take a look a recent National Institute of Health (NIH) trial comparing a low carb animal based diet to a high carb plant focused diet.

Published in Nature Medicine, the NIH trial was relatively small and focused on short term results. Researchers housed the participants in a NIH controlled facility, proving to increase the internal validity and controls of the...